IntraOp Findings
by the frustrated writer
Summary: There is some pathologic phenomenon happening it's the reason one goes into surgery. Identify the cause, take it out, repair, control the bleeders, and suture it back together. Then we wait. MerMark, AddiDerek, AlexIzzie
1. Beginnings

CHAPTER TITLE: Beginnings

_DISCLAIMER: I do not own Grey's Anatomy…although I am living in a world parallel to this. Just let me tell you how crazy hospital life can be like.  Please be kind. I may be a graduate of Medicine but I humbly admit that I don't know everything. Medicine can be so compartmentalized._

_Life as an intern_.

_I think 'Alex' phrased it best: And lovin' every minute of it. PLEASE R&R_

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Beauty, brains, and body. Everybody thought having all the B's in the world would give you happiness. And everybody thought I lead a charmed life. They can never be farther from the truth.

I grew up in a trailer, moving from state to state, with my mom and younger brother. My father left us as soon as he got my mother pregnant again. I was 4 years old then. We rarely stayed at a place long enough to make friends. Having no friends and little money, the only pastime I had was to read books at the local library. My love for books became a lifelong passion. I read and read about whatever I could take an interest to. I think that's a gist of my childhood.

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I could vividly remember the day when I suddenly realized my calling to become a physician. I was 8 years old then. I had been walking home from the library, armed with some books that I had borrowed from the library. I was about to cross the street when a guy on a bicycle whizzed by and rounded the corner. A sudden screech and a metallic crashing sound reverberated in my ears. The cyclist had a head-on collision with a speeding vehicle. I hurried over, dropping my books on the sidewalk in my haste. A couple of carpenters from a nearby construction site rushed to the scene while a lady in a fashionable yellow dress and hat emerged from a beauty parlor and immediately followed.

The guy looked like hell. He was on his side with his neck was angled like a ragged doll's while the lower half of the body was pinned down by his bike and under the car. His face was unrecognizable because it was full of blood. The lady in the yellow dress kneeled beside the unconscious man and motioned to the driver to move back his vehicle. Taking care not to jostle the body, she placed her arm on the man's back and head. She began wiping the blood oozing to his face and seemingly taking in the extent of the injuries by feeling the man's head.

An elderly man appeared from behind the wheel that crashed into the cyclist. His jaw was hanging open. "I swear to God he came out of nowhere!" He bent over the cyclist and was about to move him when he heard the lady in the yellow dress yell.

"Don't move him! Call the ambulance," the lady starting firing orders to the other passersby. "Get me two small sandbags and a long board wide enough for his body." She kneeled over the cyclist and carefully opened his eyes. "Sir! Sir! Wake up!" The man was unconscious.

The elderly man knelt beside the lady and began sobbing.

The construction workers looked at each other. The beautician from the parlor ran to call the ambulance. One of them spoke up. "Hey lady, you can go back to the parlor now. I think we can handle it from here. We can carry him to the nearby hospital."

The lady in yellow looked up at the men. "I said call the ambulance! I'll take care of him for the mean time. And don't you dare move him or he might become paralyzed. Get the sandbags and board!" She turned to the unconscious man again and tried to wake him up.

"Hey Bill, just follow what the lady says," one of the workers said to the arrogant construction worker.

"I'm not gonna follow some blonde broad who thinks she knows better." And with that, Bill the construction worker crossed his arms over his chest and refused to budge.

Another worker ran to get the board and bags and returned shortly.

The lady in yellow dress began to work immediately. She inserted her small handbag under the man's neck, set the board on the unconscious man's back, and pushed him towards the ground. She placed two sandbags on both sides of the man's head. She placed the back of her hand near the nostrils and felt for the pulse near the man's throat. "Damnit!" She thrust down the man's jaw to open it. Pinching his nose, the lady locked her mouth on the man's and blew air into it twice. Placing her clasped hands over the man's chest, she began pumping. "Two, three, four…where's the ambulance?"

The beautician reappeared from behind the crowd that had gathered, looking frightened. "They said they'll be here in a while."

The faint sound of an ambulance siren gradually became louder. The lady in yellow continued pumping the chest while the elderly man blowing air into the man's mouth alternately. The paramedics have arrived. One of them was carrying a black toolbox and an ambubag; he pressed the mask on the man's open mouth and began bagging rapidly. Another paramedic joined the lady in yellow and took over pumping the man's chest. "What happened?"

Still kneeling on the pavement, the lady in yellow was busy wiping away her perspiration with a white hankerchief. "Head-on collision, around five minutes ago. He was on his right side with his neck hyperextended; lower extremities were pinned down by the bike and the vehicle. There's swelling on the frontal area, probably underlying fracture. Around 3 by 5 cm indentation on the occipital; no blood. Bleeding seems to be coming from scalp, moderate in amount. He's GCS 3." A cervical collar was placed on the man's neck. The lady in yellow stood up and collected her handbag. The paramedic was about to open his mouth to ask another question but was cut-off.

"I didn't get the name. They wouldn't help me." For the first time, she took notice of her surroundings. She glared momentarily at Bill, who shifted his stance uncomfortably. "Go! He doesn't have much time."

The paramedics immediately transferred the unconscious man onto a stretcher and brought him inside the ambulance. "Thank you," the paramedic said, and closed the ambulance doors. Within a few seconds, they were gone.

The lady in the yellow dress sat down on the sidewalk bench and sighed loudly.

All the time, I had been standing on the sidewalk, frozen by what had transpired. I saw my first sight of blood. Crowd dispersed; Bill and his co-workers went back to work. The beautician went back to her parlor and retrieved a glass of ice-cold lemonade for the lady in yellow. "That was quick thinking, Doctor!"

The lady in yellow smiled wearily. "Hmmm." She took a huge gulp of lemonade and fixed her dress. As I remember, she was actually elegantly dressed in pearls and a yellow dress, with her dainty hat askew on her blonde head. She returned the glass to the beautician. "Thank you for the lemonade, Merle. I have to go."

The Merle went back inside her parlor with the glass and left the two of us alone.

The lady doctor fixed her hat and assessed the damage on her stockings; there were large holes on her stockinged knees, so she took them off there on the bench. "Your first sight of blood, my dear?" The doctor looked up at me while placing back her shoes.

"Yeah" was all I was able to answer, still stunned. I stood there, not moving and just staring stupidly.

The lady doctor stood up, smoothed down her dress, and began picking up my books. She handed them back to me. "I can see you like reading. Well, here's an advice. Study hard and follow your dreams; you'll eventually get there." And with that, she was gone.

For all I know, I could've stood there for a few more minutes or hours. I don't remember much anymore of how I was able to go home. But as I lay on my bed that night, I had the vision of myself saving lives.

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The pager beeped, such a loud irritating sound, which jolted me back to. CALL 55.

I was in the callroom, resting for fifteen minutes before I go back to the ER 'jungle' trauma section. I've been assigned there for a week to stitch back trauma patients.

55.

"Dr. Stevens here."

"Doctor, you're needed here. There's a trauma patient waiting for you. 32 year-old male, stabbed on the anterior thorax with an ice pick…"

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When I got there, the patient was gasping in his oxygen mask and wincing in pain. The ice pick protruded from the right side of his chest in an awkward angle. I put on a pair of gloves and called a nurse from the station. "Please assist."

I turned back to the patient, glanced at his nametag, and quickly introduced myself. "Dr. Stevens, Mark. Don't bother to talk just yet. I can't remove the ice pick from your chest yet, lest it does more harm. We'll do a CT scan to make sure of the extent of your injuries then we'll proceed to the Operating room to take it out." Mark nodded in silent assent.

A sterile towel was handed to me by the nurse. I twisted it and looped it around the ice pick to stabilize it. "Please send him to the CT scan. Collect blood for Spec M and give him ATS when he gets back. Get the blood type and prepare 1 pack pRBC for possible OR use." I took off my gloves and wrote it down on the patient's chart.

Mark was wheeled out of the room without delay. I went to the nurses' station and called Bailey. "I'd just like to refer a 32-year old male, Caucasian, stabbed on the right anterior thorax with an ice pick around 30 mins ago. Vitals are stable except for his RR. I stabilized the ice pick and sent the guy to CT. Will relay the results in a while."

The Nazi spoke in a bored voice. "So what's your plan after the CT?" I can hear her chewing her gum from the other side of the line.

I shifted my weight to my right leg. "I'm expecting fractured ribs on the 3rd to 4th, hemothorax on the right, and probably injury to the anterior upper lobe of the right lung. If that's the case, I'll refer him to the TCVS and send him to the Operating room at once."

"Alright, Stevens." And without so much as a goodbye, Bailey hung up.

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Later that afternoon, I was taping the gauze on Mark's chest after doing a CTT insertion. Mark was lucky after all. His lung was spared; the downward angle of the ice pick upon entry made it possible, missing his lung by just centimeters. "You know, you're one lucky guy."

Still breathing rapidly, he smiled. "With you as the doctor, I definitely am." He winked at me.

It turned out that his girlfriend, in a sudden fit of jealousy, was the one who stabbed him. I had guessed correctly. Females usually tend to hold a knife above the head and stab in a downward motion.

"Well, that's that." I had finished taping and had adjusted the tube draining the blood from his lung cavity.

"Thank you, Dr. Stevens."

I smiled at him and exited the room. I bumped onto someone in the hallway and the chart fell from my hand. "Oww." I picked myself up and rubbed my shoulder. I bent to pick up the chart.

It was Alex. Crap.

Just a few days ago, he had photocopied pictures of me when I had modelled for the Bethany Whisper lingerie ad and plastered these all over the hospital. Since then, the male species in the hospital, from the attendings to the orderlies, began giving me furtive glances, snickering behind my back, and even began texting me anonymous lewd messages. Internship was hard enough as it is; having horrible interpersonal relationships makes it much worse.

"Heya Stevens. How's your day going?" Alex had his signature smug expression on his face.

I began walking furiously towards the callroom and ignored him. He walked beside me. I stopped at the nurses' station and returned the chart to the rack. Alex stood there, waiting for me.

I sighed. I was tired and I wanted to go home. "What do you want?"

"What are you guys doing tonight? I feel like watching the Saturday movie special on tv tonight, except that my tv got busted. Just wanted to ask if I could crash in your place to watch it," Alex replied, again walking beside me to the callroom.

Opening the door, I went to my locker. Alex followed me with the tenacity of a bulldog. I raised my brow quizzically at him. "Well, it's Meredith's house. Ask her. I don't care." I turned my back on him and opened my locker.

"I already did and she said it's ok. It's just that you're the only one who's going to be left. Meredith says she'll be out of town since she's not on duty tomorrow. O'Malley will be visiting his parents and he's on duty tomorrow."

I had forgotten that it was the Fourth of July on Sunday. Whenever there were holidays, those of us not on duty were not required to report to the hospital. So it was weekend-off for me.

"Alright, you can go." I dumped my things inside my overnight bag and went inside the changing room. I stepped out wearing my casual clothes and adjusted my belt.

Alex had my bag slung over his shoulder. "I forgot to tell you. You don't have a ride home. They've already left before you finished the thoracostomy. C'mon, I'll give you a lift."

Too tired to argue, I followed Alex to his car in the parking lot. It was a beautiful, silver Porsche; I admired it reluctantly. He opened the passenger door and placed my bag at the backseat. He gestured for me to go inside and shut the door when I got in.

I must have dozed off as soon as the car pulled out of the parking lot. The next thing I knew, we had arrived at Meredith's house. Unlocking the door, I went inside still groggy with sleep deprivation and left my bag on the floor. "Just make yourself at home. There's some more beer left in the fridge. I'm going to take a bath." I left Alex at the foyer while he situated himself at the living room and opened the tv.

I went straight to the bathroom and opened the faucet in the tub. Hot steam began to fill the room, misting the mirror. Finally, I thought, I could have some peace and quiet. I quickly peeled off my clothes and poured the bath salts and oil into the bath. Gingerly testing the water with my hand, I was satisfied with the temperature and closed the faucet. Turning on my mini I-pod to full blast and lighting some aromatherapy candles, I eased myself into the bubble bath and closed my eyes.

Mary Black was crooning softly Moon River in the background.

Thoughts that I've been holding off while being at the hospital suddenly came back. Things aren't going on so great with Hank. Although I can say that we don't argue that much, I honestly believe that there's something wrong. We do have our differences and similarities. We both came from the same background---we worked to support ourselves to be able to study and pursued our dreams. I guess that's why we clicked in the first place. Being far enough from each other as is and with a schedule as crazy as mine, I can sometimes feel his sadness whenever I have to put down the phone and rush off to do hospital work.

Yes, I know he understands me. And I can feel that he honestly tries not to mind. But I guess even I feel that I don't deserve such a great guy like him to just hang around all day and wait for me. That was an unspoken agreement that both of us won't try to hinder the other in pursuit of one's dreams. We know we've worked so hard and sacrificed so much for these. I don't want the burden of someone waiting for me to get on with his life.

Crossroads. We meet people everyday, not knowing if these people are the ones who'll walk the same roads with us throughout our journey or if they'll be the ones whom we'll just come across with along the way. It's sometimes sad to see those whom we expect to be with us throughout our lifetimes to be the ones who'll end up just 'passing by.'

There was a knock on the door. Alex's voice was muffled as he shouted. "Stevens, I'm hungry. What's for dinner? You want me to order pizza?"

My stomach suddenly grumbled. I had forgotten to eat lunch again as usual, running all over the hospital today. "I can whip up some pasta and you can order pizza. Be right out in a few minutes."

I had to smile. Even company as sinister as Alex can comfort me in these times. At least, I'm not alone with this kind of lopsided life.

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_To be continued. _

_Well, how was it? Hope it turned out all right. I must admit, English is not my primary language. So if you think I write funny, I have an instant excuse.  It's just hard to describe certain medical procedures in layman's terms. Here are some so you won't get lost:_

_Occipital – part of the skull which is the back of one's head_

_GCS 3 – Glasgow coma scale rating consciousness, eye opening, and movement of _

_extremities. GCS 3 is the lowest rating one can give to an unconscious patientwho doesn't respond to verbal nor painful stimuli_

_CT scan – you probably wondered: Why not an xray? Yeah, well this is fiction. And I just wanted to place importance to the danger Mark would've been if the ice pick had punctured his lung. CT scan can be used to visualize the soft tissues, unlike the xray which is more used to visualize bones. In reality, Izzie should've ordered the xray and took out the ice pick at the OR, then do a CT scan post-op for the damage to Mark's lung. You can't do a CT scan without taking out the ice pick because the CT scan is sort of large magnet that takes pictures of the specified areas. But hey, that's creative writing for you. _

_Spec M – this is just a short cut for lab tests: complete blood count, et al_

_ATS – this is anti-tetanus since Mark's chest was pierced by a foreign object _

_pRBC – packed red blood cell for transfusion since Mark lost some amount of blood_

_OR – Operating room_

_RR – part of the vital signs; respiratory rate_

_Hemothorax – blood in the lung cavity; the reason why Mark's breathing pattern was shallow and rapid. His right lung can't expand fully in its cavity because of the blood that's taken up space_

_There you go, I hope you'll forgive me for whatever typos and grammar problems you've seen here. Please be kind; it's my first fanfic. Will update soon…_


	2. Serendipity

Chapter Title: Serendipity

Author's notes: Please bear with my style of writing. I will now go back to the time before Derek and Meredith even dreamed of being physicians. This scene may remind you of a certain movie I won't mention so as not to preempt my story. Please read and review.

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I just love ferry boats, especially when riding one early morning. I am not a creature of habit; but this has been the only ritual that I've ever acquired: I ride the ferry boat to school, with my cream cheese bagel and coffee in tow. I absolutely enjoy the crisp sea breeze and salty spray on my face while I finish off my breakfast on the deck, watching the orangey-pink sunrise. I usually watch people and notice the little details. I wonder about them: who they are, what they do, et al.

Of all the people I've watched, I noticed this particular girl one morning.

I was seated on the last chair at the last row. There have only been five of us that morning. One woman was with her 4-yr old child, who lay sleeping on her lap. An old man with a white beard who was quietly smoking a pipe.

The girl's back was turned to me. She had strawberry blond hair and was wearing a heavy black coat. She was throwing things one by one from a shoebox that she held in her arms. Curiously, I got up, pretended to be seasick so I could lean over the railing and take a good look at her and what she's up to.

The first thing I noticed about her were her eyes. They were probably the saddest pair of eyes I've ever seen. Blue-gray, heavily lashed, and sparkling. With tears? I thought. She suddenly looked up and our eyes locked. She was the first to look away.

Now, I was a true-blooded New Yorker, indifferent and minds his own business. I was never the type who would approach total strangers and casually ask them if they were okay. Really now, who does that nowadays? But I surprised even myself that day when I found myself already infront of this sad young woman. "You know you could just dump everything from the box into the ocean and be done with it." I leaned on the railing and was pretending to look at the sky.

Surprisingly, she smiled. I will always remember that first smile as her signature smile, the way her lips crinkle just a little at the corners. "I agree. But it won't be half as satisfying to see one after the other float away."

"Ah," I nodded, smiling back at her. "Catharsis. Well that's good. They all say that to be able to move on, one must unload unnecessary baggage. Good point."

She laughed. "I guess you could call it unnecessary baggage. And it can either be a problem or a situation, depending on what the burden is."

I raised an eyebrow. She's witty. "A problem has solutions." I paused.

She sighed, such a long sad one, not looking nor smiling at me anymore. She stared straight ahead at the ocean. "When you're in a situation, there are no solutions. You can only brave the storm and wait for it to subside. You're helpless and with every counteraction you try to do, you run the risk of it backfiring on you, thus worsening things." She faced me again. "I'm Meredith by the way."

I shook her hand. "Derek. Listen, the boat's about to go into the dock. I was wondering if you'd like to have breakfast with me. There's a quiet cafe nearby, serves humongous blueberry waffles. A quick salve for heavily burdened souls who have just recently unloaded baggage into the ocean."

She laughed. "Blueberry waffles it is. Lead the way."

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Breakfast ended a long time ago. It turned out that this was Meredith's first time in New York. So we went to a small surplus shop, bought a blanket, and headed off to Central Park. She was so easy to talk to and fun to argue with.

I spread the blanket on the grass and Meredith sat down. "Don't you have anything planned today," she asked, squinting up at me as I was removing my shoes before I sat down beside her.

I gave her my best "hurt" look and she laughed. "I meant that I may be keeping you. In that case, I excuse you from any responsibilities you might feel in touring me across your fine city."

"If you want me to leave you alone, just say so," I demurred, smirking playfully and rolling my eyes. I leaned back on my elbows. "Why are you in New York anyway?"

It was her turn to smirk playfully and was looking straight ahead at a distance. "I broke up with my boyfriend. He cheated on me and I couldn't stomach it."

"How typical," I snorted. "I bet he feels jealous of you. His ego couldn't handle it." She looked at me like she didn't know what I was talking about. "What? I'm telling you, the man's jealous of your achievements. It's a macho thing, don't worry. I see it all the time." I laughed at her perplexed look. "It was never 'you' as the reason why you guys split up. It sounds cliche but I'll say it anyway." I paused for effect. "It's not you, it's him."

Meredith laughed out loud this time. She had a nice laugh, hearty but not too boisterous, and with a tinkling quality to it. Shaking her head, she replied, "How good you are for my ego. Maybe next time I should get me someone with a been-there-done-that attitude."

And that's how it was for the whole day. Meredith and I just roamed around Central Park, talking and laughing like old friends. It has been a while since the last time I talked to someone, as in really talked to. Although basically we didn't talk about anything relevant in our respective lives, it was the rapport, the easiness of our conversations, and the sincerity between the words, were what immortalized that day for me. How I loathed when it ended.

We were infront of Meredith's hotel on the sidewalk that night, facing each other.

Meredith spoke, her smile lighting up her blue-gray eyes. "Thank you for everything, Derek. It was a wonderful day. I can't tell you how much I enjoyed it." She looked awkward, for the first time since we met that morning. Meredith offered her hand.

I smiled at her and engulfed her hand in mine. "Pleasure's all mine. Glad to be of service. I'm just doing my city a favor by touring a young lady on her first time here. Maybe she'll begin to like it enough to stay longer to get to know more of it," I hinted.

"I have to go," Meredith stammered a little and gestured with her hands. "Thanks again." She tiptoed to kiss my cheek while I bent down to kiss hers. We bumped noses in the process and our lips met. A warm feeling spread across my face. Finally, Meredith broke off from our kiss and hurriedly went to the revolving doors.

I shouted frantically. "I'll see you tomorrow morning!"

Before she pushed the door open, Meredith looked back one last time at me.

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The next morning, I went to the hotel where Meredith was staying and came looking for her. The concierge thought I was a little loose on the head. Fortunately, the bellhop remembered Meredith and told me her room number.

When I got there, the door was ajar. I went inside cautiously. "Meredith? It's me, Derek. Are you decent?" I was smiling, sniffing on the bouquet of wildflowers I got for her.

A Mexican-looking woman in a maid's uniform went out of the bathroom carrying a hamper with used towels. "I'm sorry but our previous guest checked out early this morning."

I stood there, frozen to the ground, as my spirits took a nose-dive.

That was the last time I ever saw her. I didn't know where she came from, nor at least what her last name was. It was like waking up from a beautiful dream I had.

Over the years, I still thought of Meredith once in a while. I never looked her up in the internet, once I got her name after bribing the concierge that day. It had been my theory that these things happen for some reason. There are some things that we can help ourselves to and there are some that any form of intervention would ruin everything. And I believe that this time, it was the latter. I just had to have faith.

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	3. Reflections

CHAPTER TITLE: Reflections I

_Derek looks back on what went wrong. _

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_New skylights. _

I downed my drink, double scotch, single malt. "One more please."

Joe the bartender slid a glass infront of me. "Take it easy there, man. I see you're new here. Work anywhere I know?"

"Just moved in today, Joe. I start tomorrow, hospital across the street. Seattle Grace." I gulped down my drink.

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_New York became to too small for me, my estranged wife, Addison, and my ex-bestfriend, Mark. I left, without looking back._

_Being indifferent and avoiding the situation work for me. I'm just too exhausted to think about anything anymore. My choice of a career already puts so much stress. I don't need the added burden._

_Ironic that for someone who saves lives, no one can save mine. Doctors, truly one of the loneliest kind of species in the world._

_I can't blame Addison for Mark. I wasn't there most of the time. They may have committed the crime but I made a huge contribution to in setting up the recipe for disaster. It's the sin by omission. _

_I loved Addison, with every fiber of my being. She was the beautiful, strong, independent woman who would support you in everything. Everybody envied the day we got together. We were being called "The Golden Couple" behind our backs: I, as one of the best in the field of Neurosurgery, and she, one of the best in Obstetrics and Pediatric Surgery. Both of us pioneered several approaches and procedures in our respective fields. We were revered and loved, individually. _

_As most marriages go, the years passed and everything became routine. I would be home and she would be at the hospital doing a C-section. She would get home and I'd be on my way to the hospital to do emergency Craniotomy. We were both on-call every day of our lives. I grew used to it, due to my very adaptable nature. Apparently, she didn't._

_Now Mark has been my bestfriend since our days in Harvard Medical. We accidentally met while we were both going to ask the same girl to go out for coffee (my idea), and for drinks (his). We ended 'hooking up' together instead. _

_We were different as night and day, Mark and I. I was the charming extrovert; he was the arrogant, reserved type of person. I befriended women; he bedded them. I had long serious relationships; his own was lucky to even last a month. We were always pitted against each other, in academics, in sports, and in women. Both of us took it goodnaturedly. After all, brotherhood lasted longer than women. Or so I thought._

_I met Addison while already working in the hospital. She referred a trauma patient to me for Neuro clearance before proceeding with an emergency C-section. The usual happened. I asked her out and we went out for dinner. We just clicked. _

_Addison was convenient for me. She was my rock. We always argued about the littlest things, from how to properly squeeze the toothpaste to which restaurant we would dine out. Whenever I had a bad day at the hospital, I would go home and on the rare occasion that she's there she'd immediately ask how my day was and give me a back rub. She always took care of things for me._

_Time goes by and both of our respective practices grew. We had less time for each other, rarely went out. Mark was an only child; both his parents had died while we were in med school. He didn't have any family to go to. Three of us started a Christmas tradition of putting up the tree, decorating it, and having Christmas dinner. We started inviting Mark when I would be called in for yet another stat procedure. Then came Thanksgiving, and birthdays, and family reunions. He became Addison's best friend too._

_Since most of Mark's practice consisted of elective procedures, he had more control of his time than Addison and I. Whenever he'd get bored with one of his women of the moment, he'd invite both of us for dinner, cocktails, or sometimes an out-of-town trip. And when I couldn't make it, they go off on one of their 'dates.'_

_Was I jealous? In retrospect, I was never a jealous guy. Especially of someone who's practically my brother. Never once did I doubt Mark or Addison. Until that time when I saw them in our bedroom._

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I downed my drink in one gulp. "Another one, Joe."

Joe placed another glass. "What are you having," Joe asked the woman who just sat a couple of stools to my right.

"Double shot of tequila," she replied, pulling back her long strawberry blond hair from her face.

I was drawn to her; there was something familiar about her. Adequately inebriated, I found the courage to sit beside her and offered to buy her a drink. "Hi, I'm Derek." I offered my hand which she shook, her small hand engulfed in mine. "I'm new in town."

"Meredith," she replied, her smile dazzling. "You remind me of someone."

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Please read and review! Thanks a lot! Please be patient with my plot.


	4. Lost

A/N: This is where I verge to my personal choice of fictional ending in the episode where Meredith chose to stay with Derek instead of choosing to have a fresh start with Mark.

CHAPTER TITLE: Lost

_So there really is no starting over for me here in Seattle. To the rest of the world, I'm the chump who seduced his bestfriend's wife. In Seattle, I'm the 'Dirty Mistress.' Honestly, I did believe I was in love with Addison. And when I want something, I fight to get it. _

_After all, I am Mark Sloan._

_I never really fit in anywhere. Growing up was hell; my parents were quarrelling most of the time. Amidst the fights and screaming, I mentally blocked out everything. I took to the streets and been with juvenile gangs in those days. Yet in spite of everything, I became disgusted when my so-called friends began drug trafficking and doping up. I wanted more from life than to be an addict and a criminal. I realized that the only way that I could truly escape my family was if I become independent. My choice was either to go on a downward spiral into a black hole or to stick it out and fight like hell to get out._

_I made my choice. I am going to survive. I stopped cutting classes and cleaned up. I began studying, got excellent grades, and worked my way through college. It was hard, juggling the academic work with physical labor, but it paid off. _

_In Columbia, a lot of snobby, preppy girls came on to me. I had a summer job then after my first year of college, working as the pool maintenance guy in the country club. I'd see their perfect, tanned bodies sunbathing, sipping their little umbrella'd cocktails, and flirting with me. I once tried dating a socialite after weeks of flirting with me and that experience taught me a lot._

"Do turn off the lights, Mark," Adrienne asked, pulling her silky hair into a ponytail. I turned off the lights, slowed her little red convertible, and parked under a tree a block from her mansion. "I'll pick you up same time tomorrow at the back of the diner." She zipped up her jacket and smoothened her skirt.

I was getting sick of the booty calls in the middle of the night and the secret dates we had. They weren't actually dates; we would just have sex in a nearby motel. "This is the last time I'll go out like this with you, Adrienne. I can't take all this secrecy anymore. If you want to go out with me, I'll take you out on a regular date. I'll pick you up from your house in my pick-up and we'll actually eat in the diner with what my meager salary can afford."

She looked at me and crossed her arms across her chest. "Honey, I know you need the money that's why I insist on paying. Plus you know very well we can't go out in public. My family will be scandalized and my dad's going to kill me!" Adrienne is the only daughter of the Governor. She purred and began rubbing my thigh. "He's going to run in the upcoming elections."

I looked at her in her pastels and cardigan and expensive manicure as if seeing her for the first time. She's nothing more than a mindless, rich, spoiled brat who wouldn't be able to survive without Daddy's money.

I raised an eyebrow and gave her my signature deadly smile. "Then I'll just make this easier for the both of us. It's over." I quickly got out of her car and walked down the quiet tree-lined street without ever looking back.

_After that, I learned to use women and let them use me. There were no pretensions, no promises, and no guilt. I never had a failed relationship; I conveniently never had one._

_My parents died in a car accident sometime before I chose to pursue Medicine. They left me quite a hefty sum of money from the insurance I never knew my dad had. So I researched on how I could make more money out of it and placed half of it in the stock market, buying shares of a company named Microsoft. It paid off, so well in fact that when I had entered medical school I was already a self-made man. _

_I bought a whole floor in a building in the Upper East and converted it into a bachelor's pad. I bought a couple of Harleys and a Ducati. I had millions in the bank. I had everything I needed._

_I went to Harvard for med school and met Derek there. We were always in competition for the highest grades, for being captain of the rowing team, and for the women. Years had passed and I was still attracted to the wrong women – women too beautiful, too rich, and too good to be with someone like me who came from the Bronx._

_Like I said, I always felt like the outsider, even after I was done with my surgical residency and finished a subspecialty in Plastic and Reconstructive Surgery. There is just something about my shady past and unorthodox upbringing that made a handful of women I've gone out with, who were surprisingly astute enough to sense that I was not what I seem to be, become disgusted with me. Being with people like Derek who came from a distinguished clan with very serious 'old money' immediately placed me among the crème de la crème of the East coast society. Yet, the women always found my aloofness, arrogance, and cynicism both intriguing and exciting. _

_Then came Addison. I had been in training in Thailand for two years while she and Derek met and dated. A month before they were married, Derek called me to come home to New York and be the best man in his wedding._

I had leased my pad for the past two years that I was abroad so I naturally crashed at Derek's house. I opened the door to his townhouse and brought my suitcases upstairs. Years ago, I always stayed there whenever we'd go out to a boys' night out in town, far safer than going home drunk-driving on a motorcycle. I showered and changed into boxers, meaning to get a glass of scotch after the long intercontinental flight. I quickly went downstairs to the kitchen.

Someone immediately gasped. "Ach!" A beautiful, red-haired woman clad in a flimsy floral nightgown materialized in the kitchen. "You scared me to death!"

I chuckled, offering my hand. "I take it you're to be the future Mrs. Shepherd? Mark Sloan."

Shaking my hand, she smiled. "I'm Addison Montgomery."

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_I was both their bestfriend. I was there for both of them. I never knew what having a family felt like until I was irrevocably adopted into theirs. They took care of me and I took care of them. Then came the Christmases, the Thanksgivings, the birthdays, the anniversaries, and the reunions. _

_You see, this thing with Addison surreptitiously made its way into my heart. One never bites the hand that feeds him. She was family to me. Looking back on all things said and done, I had no foresight on what was to happen. I never thought of her in a romantic kind of way. Plainly, I just had never been in love before. So it was never just a one-night stand for me; this thing took years in the making. I never consciously tried to break up their marriage. And I swear that I was sure to stop myself had I figured earlier what was to happen._

_Late into their marriage, Addison and I were left alone most of the time. Derek had become lazy in working on their marriage. Knowing Derek, he had become indifferent to Addison and preoccupied with work. With Derek always away, Addison became more preoccupied with me. I noticed the 'little things.' She goes to my pad and brings groceries. She sometimes drops by to have my clothes laundered with theirs. I never asked her for these things and yet she just does._

_I became more and more aware of her qualities – her kindness, compassion, thoughtfulness, vulnerability, strength, and sincerity. Naturally, I began taking care of her too. I'd call in by lunchtime to ask her if she'd eaten or just call to ask how her day was. I took Addison to dinner, to plays, and eventually their family gatherings even. They saw more of us than they saw of them together._

That fateful night, I saw her crying over the rack of lamb that she was marinating for dinner.

I placed my keys on the kitchen counter to let her know I was there. "What's wrong?"

I never saw her looked so sad and so tired before. Taking in her puffy, red-rimmed eyes, I held her there in the middle of their kitchen. "Tell me what's wrong, Addison."

Addison buried her face and cried some more. "I had just finished marinating the lamb and I don't know what came over me. It just hit me that I'll be dining alone again and here I am crying and I can't seem to stop."

"You want me to call Derek?" I stroke her back, gently urging her to cry it all out.

Awkwardly, she stepped out of our embrace. "I don't want to disturb him. He's probably saving a life, you know." She sat, dousing her face with water from the faucet and wiping her eyes. Addison looked down on her hands. "I'm sorry you saw me like that. I've been having a hard time pretending Derek hasn't been indifferent to me for a long time now. I just don't know what to do anymore. I just feel so lonely sometimes."

Sitting down across the counter, I sighed. "You know I know absolutely nothing about relationships. I don't know what to say. But I know Derek. He's just really preoccupied with work. You know how he can be so attached to his patients." I snatched the recipe book from the bookstand. "Well, I'm here, aren't I? And I'm famished. Come on, I'll help you cook that lamb." I got up and began tying the strings of her ridiculous "Kiss The Cook" apron behind my back.

Seeing me decked out in a frilly pink apron and oven mittens, Addison forgot about herself momentarily and raised an eyebrow. That statement wrung a laugh out of her. "The great Sloan can cook a rack of lamb?"

I winked at her, got the baking pan with the lamb on it, and placed it inside the oven.. "Of course, I can!" I looked down on the recipe book and quoted. "'Turn oven to 345°C and bake for 30 minutes.' See, any idiot can do that." I place both my hands on my hips and nodded to the oven.

We had a delightful dinner that night, as always. Over candlelight, we talked and laughed and drank a lot of wine. When we ran out of wine, we finished off the scotch and the vodka.

After a while, Addison was slurring and jabbing her finger on my chest. "You know, you shouldn't be right here consoling me. You should be out there on the streets, prowling for some unsuspecting woman, and making her fall head over heels in love with you. You've been on the market for too long, Mark." She laughed out loud and slapped her thigh at her 'brilliant' idea. "Time for you to make someone miserable too!"

I wiggled my eyebrows. "Maybe you're right." I was slurring a bit myself. "I just hope as hell I'd be as lucky as Derek to find someone like you." I laughed and pinched her cheek like a cute toddler's.

In retaliation, she swung her arm to punch me playfully on the arm. Outbalanced, Addison fell on her side and hit her head on the floor.

Setting my glass on the table, I laughed and nudged her leg with my foot. "Hey, Addison. You're so stinking drunk."

When she didn't appear to move at all, I got down on my knees and lightly touched her cheek. "Addison? Wake up!"

A smile playfully tugged at the corners of her mouth. She opened one eye. "Gotcha."

"You asked for it!" I began tickling her sides mercilessly until she was laughing with big fat tears were rolling down her face and was begging me to stop. I stopped and she stopped laughing. Addison suddenly crumpled into my arms and began sobbing this time. I just held her there, both of us on the carpeted floor. I felt sorry for her then. Derek should be the one holding her now. He was, after all, the cause.

I began stroking her hair and brushing the tears from her eyes.

I never consoled a crying woman before; I always ended my relationship with a quick 'This isn't working out' speech and quickly walking away before I see them cry. This was different. I was not breaking up with her; she was a friend. I didn't know what to say.

I kissed her hair, and then her forehead. She looked up at me with those beautiful tear-filled eyes with so much longing. I kissed her eyelids and her cheeks. "Oh Addison."

Her pleading eyes, her soft body clinging to me, and the scent of her hair. All that and the liberal, alcoholic pre-loading that we had imbibed had suddenly filled my senses. All my self-control left me. I closed my eyes and kissed her lips.

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_I guess the reason why I was drawn to them was because I envied them. They had each other, have wonderful families, and were respected. I see every look that passed between them in silent communication, the way one of them unconsciously touches the other, or even the way they move were subtly alike. I envied their happiness. Maybe for some unknown, unspoken wish, I had wanted some of that could rub off on me too and that I would be able to find someone who's like Addison to Derek._

_I never imagined I would end up breaking the marriage that I swore to protect, and hurting the two people I loved and trusted most in the world._

_Sorry just doesn't begin to cover it._

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See? Mark isn't as shallow as they depict them to be on screen. He just hasn't found someone to shake that cynicism off him even just a little bit. Read and review please!


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